Efficacy of musical training on reducing depressive symptoms, and enhancing self-esteem and quality of life in Hong Kong Chinese children and adolescents who have survived brain tumours : a randomised controlled trial

Abstract

Compelling evidence has shown that paediatric brain tumours survivors (PBTS) experience more negative psychological sequelae, particularly a greater risk of depression, than do survivors of other paediatric cancers. Cancer and its treatment can have long-lasting negative effects on the psychological well-being of PBTS and consequently cause long-term decrement of survivors’ quality of life (QoL). There has been an increase in the use of musical training for the promotion of psychological well-being in individuals with psychiatric problems. Nevertheless, the efficacy of musical training in promoting psychological well-being in children and adolescents who have survived brain tumours remains unexplored. This study aimed to examine the feasibility and efficacy of a musical training programme in reducing depressive symptoms, and enhancing self-esteem and QoL in Hong Kong Chinese children and adolescents who have survived brain tumours. Prior to an intervention study, the psychological well-being, including depressive symptoms, level of self-esteem, and QoL, of Hong Kong Chinese children and adolescents who have survived brain tumours was assessed. A randomised controlled trial (RCT) was then conducted. A total of 60 eligible children and adolescents aged between 7 and 16 who have survived brain tumours were recruited in a paediatric oncology outpatient clinic of an acute public hospital in Hong Kong. Of these 60 participants, 30 were randomly allocated to the experimental group to receive a weekly 45-minute musical training session for 52 weeks delivered by professional orchestral performers at the participants’ homes, and 30 were allocated to the placebo control group to receive a placebo intervention for 52 weeks. Data on participants’ depressive symptoms, level of self-esteem and QoL were collected at baseline and 6 and 12 months after the intervention began. Overall, a total of 56 (93.3%) participants completed the study, with 29 from the experimental group and 27 from the placebo control group. Analysis was carried out based on the intention-to-treat principle. At 12 months, the experimental group had reported significantly fewer depressive symptoms, higher levels of self-esteem, and better QoL than the placebo control group. This is the first study examining the efficacy of musical training for PBTS. The findings provided further evidence that a musical training programme is effective in reducing depressive symptoms, and enhancing self-esteem and QoL in Hong Kong Chinese children and adolescents who have survived brain tumours. Specifically, this study showed that a weekly 45-minute musical training session for 52 weeks is sufficient and effective to ameliorate depressive symptoms and improve self-esteem and QoL in Hong Kong children and adolescents who have survived brain tumours. It provides evidence for parents and healthcare professionals that musical training is not only a leisure activity, but also exerts therapeutic effects in promoting psychological well-being and improving the QoL of PBTS. In addition, this study demonstrated that the musical training programme is feasible for implementation in the Hong Kong context and enjoyed and accepted by children and adolescents who have survived brain tumours.